HomeMy WebLinkAbout1975-10-28 Water & Sewer Hookup #4239Contractor ' _�r L AQ Address
Owner. r'1 Address--
State
ddress
State License No. — Village License No
Parcel No.
Section No
Plat No.
Other Description:
Village Permit N° 4239
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Ray, Minnesota
Lot Block Subdivision
Date " A-7 S`
I hercb)' agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems
Install Water Hookup:
Install Water Supply Systems:
Install Sewer Hookup:
Fee S
Fcc S % L
Fee S
Fee S
Fee S
FeeS�A--
Fee S
State Surtax: Fee S /' to c
Total Amount Paid to Village........... Fee S
Signature of applicant
Signature of Village Uffici 1